Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lacking. This is known as "fluffing". Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol. It is not restricted, and many brands are available on the Internet. The use of injected oil to enhance muscle appearance is common among bodybuilders, despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma, stroke, and the formation of oil-filled granulomas, cysts or ulcers in the muscle. Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.
Weight training aims to build muscle by prompting two different types of hypertrophy: sarcoplasmic and myofibrillar. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy, which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weight. In either case, there is an increase in both size and strength of the muscles (compared to what happens if that same individual does not lift weights at all), however, the emphasis is different.
This period also saw the rise of anabolic steroids in bodybuilding and many other sports. In bodybuilding lore, this is partly attributed to the rise of "mass monsters", beginning with Arnold Schwarzenegger, Sergio Oliva, and Lou Ferrigno in the late 1960s and early 1970s, and continuing through the 1980s with Lee Haney, the 1990s with Dorian Yates, Ronnie Coleman, and Markus Rühl, and up to the present day. Bodybuilders such as Greg Kovacs attained mass and size never seen previously but were not successful at the pro level. Others were renowned for their spectacular development of a particular body part, like Tom Platz or Paul Demayo for their leg muscles. At the time of shooting Pumping Iron, Schwarzenegger (while never admitting to steroid use until long after his retirement) said that "you have to do anything you can to get the advantage in competition". He would later say that he does not regret using anything.
In the early 2000s, the IFBB was attempting to make bodybuilding an Olympic sport. It obtained full IOC membership in 2000 and was attempting to get approved as a demonstration event at the Olympics, which would hopefully lead to it being added as a full contest. This did not happen and Olympic recognition for bodybuilding remains controversial since many argue that bodybuilding is not a sport.
In competitive bodybuilding, bodybuilders aspire to present an aesthetically pleasing body on stage. In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choreographed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
In recent years, the related areas of fitness and figure competition have increased in popularity, surpassing that of female bodybuilding, and have provided an alternative for women who choose not to develop the level of muscularity necessary for bodybuilding. McLish would closely resemble what is thought of today as a fitness and figure competitor, instead of what is now considered a female bodybuilder. Fitness competitions also have a gymnastic element to them. A study by the Clinical Journal of Sport Medicine found that female bodybuilders who are taking anabolic steroids are more likely to have qualified for substance dependence disorder, to have been diagnosed with a psychiatric illness, or to have a history of sexual abuse.
Sandow was so successful at flexing and posing his physique that he later created several businesses around his fame, and was among the first to market products branded with his name. He was credited with inventing and selling the first exercise equipment for the masses: machined dumbbells, spring pulleys, and tension bands. Even his image was sold by the thousands in "cabinet cards" and other prints. Sandow was a perfect "Gracilian", a standard of ideal body proportions close to those of ancient Greek and Roman statues. Men's physiques were then judged by how closely they matched these proportions.